Holden’s campaign fired off a response on Sunday calling the flier “pathetic.”

“It’s one of the worst and blatantly false political ads I’ve ever seen,” Holden campaign manager Eric Nagy said. “It is ridiculous to claim, enthusiastically, that Tim Holden is not ‘worried about cancer.’ ”

Nagy said one of Tim Holden’s proudest achievements as a member of Congress was securing $40 million to build the Cancer Institute at Penn State Hershey Medical Center

Cartwright based the ad on Holden’s vote against the 2010 Patient Protection and Affordable Care Act, which allows coverage for patients with pre-existing conditions like cancer. It also cites his vote in support of the Halliburton Loophole, which allows for the deregulation of hydraulic fracturing. As a result, oil companies could use cancer causing chemicals, the ad reads. Cartwright campaign manager Shane Seaver said he stands 100% behind the facts in the ads and mailings.

The final jab came after the two sides agreed to a cease fire on negative ads Thursday, with Holden saying both sides had gone too far.

Cartwright said last week that Holden’s latest television ad made his blood boil.

The ad essentially accused Cartwright of bribing a judge with campaign donations from his Scranton law firm Munley, Munley and Cartwright. Yet Cartwright’s client won the case in question because of a jury decision, not the judge, according to his campaign.

Seaver said it was disingenuous for Holden to “cry foul” at the 11th hour after the series of back and forth ads from the candidates and groups that support them.

Ads by the Holden campaign bashed Cartwright for campaign contributions to the infamous “kids for cash” judges in Luzerne County. Cartwright has sent campaign fliers through the mail that cast Holden as a villain who sides with big banks and helped extend tax cuts for the rich.

Holden, of St. Clair, Schuylkill County, has also been slammed by political organizations and action committees who favor Cartwright, a Scranton-based lawyer with no political experience. Much of the criticism against Holden has been that he is too conservative for the 17th District, which is 76 percent new territory in 2013 and more liberal because of congressional redistricting.

In 2011, Holden sided with President Barack Obama in 63 percent of his votes in 2011 and voted with the Democratic Party 67 percent of the time. But the 10-term congressman says his voting record is a reflection of his district, which had a conservative majority. Holden says he will use the same style of representation if re-elected, meaning his votes would become more liberal.

Holden is believed to be in jeopardy of losing his seat and the race has gained national attention, including more than half a million dollars spent by outside organizations and political action committees. Groups like the Campaign for Primary Accountability and The League of Conservation Voters have spent a combined $572,000 and the contest is leading all House races, aside from special elections, in outside money spent on ads, according to the Sunlight Foundation.

Matt Cartwright has picked up the endorsements of the Scranton Times Tribune and the Wilkes-Barre based Citizens’ Voice editorial boards.

Cartwright, a Scranton based lawyer and political newcomer, is trying to knock off 10-term congressman Tim Holden in the 17th District Democratic primary.

The Times-Tribune said it thinks Holden is out of touch with the district, which is about 76 percent new territory under the state’s new congressional map. The Citizens’ Voice said it believes Cartwright would be a stronger advocate for working families in the region.

But Holden announced on Friday he’s gained the endorsement of former Pennsylvania Gov. Ed Rendell. In a statement, Rendell said the district is a perfect fit for Tim Holden, as it reflects his working-class roots.

Holden will get some final face time with voters in Easton on Tuesday afternoon. He’s scheduled to eat at 2:15 p.m. at Josie’s New York Deli in Center Square. Cartwright has yet to release his election day schedule.